Houston doctor blames agencies in Medicare scam

By Terri Langford

Updated 9:46 pm, Wednesday, May 23, 2012

Houston physician Ben Echols, accused of federal health care fraud, admitted Wednesday he did not read every patient request for home health services but relied on the now-questionable judgment of the people who paid him when he signed off on bogus and unnecessary Medicare benefits.

But federal prosecutors contend the doctor's alleged conspiracy to defraud the government resulted in more than $5.2 million in bogus claims billed to taxpayers.

"I didn't take a strong look,'' Echols told jurors during testimony, saying that he trusted the home health agencies, which paid him a salary, when they claimed he was approving services for his own patients.

The Houston gastroenterologist's testimony was meant to explain how and why he referred 352 patients for Medicare-funded home health care that they neither qualified for nor needed. He insisted he did not violate Medicare rules and did only what the two companies, Family Healthcare Services and Houston Compassionate Care, asked him to do.

Echols, whose case is being heard before U.S. District Judge Sim Lake, is charged with one count of conspiracy to commit health care fraud and seven counts of health care fraud. Jurors began deliberating Wednesday afternoon.

Under questioning by Department of Justice prosecutor Abigail Taylor, the 62-year-old physician said he thought workers from the agencies were bringing him "plans of care" to be signed and that all the patients were eligible to receive Medicare-paid home health services.

He further testified that Cynthia Garza-Williams, a patient recruiter for Houston Compassionate Care, told him, "You know I wouldn't bring you no bull" before handing over the forms for his signature.

Echols, a diabetic on kidney dialysis, who had several eye surgeries, said he believed the patients he approved were his own, or had been referred to him by his own nurse practitioner.

200 had no office visits

Of the 352 patients approved by Echols, 200 did not have an office visit with him. Echols says he was the medical director for Family Healthcare and Compassionate Care - a role that required him to oversee their health care and offer training and advice.

"I signed the form for what I was thinking was keeping Compassionate Care in compliance," Echols told jurors.

Of the 352 patients who received home health care, 148 came to Echols from Family Healthcare. When asked why he would sign off on those requests, he denied that he did.

"I did not sign no 148 patients," he said. "Don't know how that happened."

He argued that the payments he received from both companies, was his salary, even though the payments varied in amounts and frequency. He denied that they were payoffs to help bilk Medicare.

More than $104,000 was paid by Compassionate Care to Echols for his services. Several thousand more came from Family Healthcare.

The papers Echols' signed certified that patients met the requirements for home health services and Echols was the patient's personal physician. It allows a home health agency to start services and bill the government for payment, under the approving doctor's billing number.

But in this case, hundreds of patients were approved, often after they were denied home health care by their own physicians. Once the companies obtained Echols' signature, they billed for services, using the patients' original doctor's Medicare number - not Echols' - making it appear that their primary care physicians had approved the services.

Medicare was none the wiser because it does not require health care companies to submit the "plans of care" with their invoices.

Owners pleaded guilty

Last year, the owners of Family Healthcare - Clifford Ubani and Princewill Njoku - pleaded guilty to trying to defraud Medicare through phony home health care claims and pointed to Echols as their partner in the scheme.

In closing arguments, prosecutor Taylor reminded jurors that Echols sold his signature to people who pleaded guilty to fraud, signing off on requests for home health care that wasn't needed and in some cases, doing so after a patient's own doctor denied the care necessary.

"This case is about the value of a doctor's signature," Taylor said. "Dr. Echols, he ignored his patients, and he chose to lie."

"Medicare doesn't care about his signature," Williams said of the form, the heart of the government's case. " Medicare doesn't see his signature. "His fault is trusting people. This man is not a thief. This man was deceived."

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